New research published in Geriatrics & Gerontology International has found that tooth loss may contribute to musculoskeletal frailty in the old people ( age>50) with fewer than 20 teeth being at greatest risk.

The researchers examined the overall health of 9,338 Americans aged 50 years and older. The final analysis involved an examination of the frailty of 924 males and 928 females, who had a mean age of 62.9 years.

Participants were categorised into three groups: those having at least 20 teeth, denture wearers with less than 20 teeth, and non-denture wearers with less than 20 teeth. The groups were tested using a combination of interviews, clinical examinations and BMI and oral health assessments, to calculate frailty.

Results from the study indicated that those with more than 20 teeth were significantly less likely to be frail than those with less than 20 teeth who did not use dentures. This group was also found to have consumed the greatest amount of nutrients over the study period.

Conversely, the group that had less than 20 teeth and did not use dentures, and those who used dentures, were found to have consumed the least amount of nutrients, when compared to the Recommended Dietary Intakes recommended by the US food and drug administration.

The team believe that the lack of nutrients being taken on board by denture wearers could be attributed to their inability to eat specific foods. Although dentures improve masticatory function, their bite force is much weaker than that of natural teeth, meaning users may avoid certain foods.

The research highlights the important need for older people to be able to maintain the ability to not just chew, but to chew effectively, in order to take on board the essential nutrients necessary to maintain muscle mass and stave off musculoskeletal frailty.

Few studies have examined the relationship between oral health, particularly periodontal disease, the number of teeth and general frailty. While others have argued that older adults who need dentures were more likely to be frail, there were few attempts to explain the underpinning cause of the relationship.

One of the important findings of the study is the significant relationship between the condition of teeth and deficiency in intake of essential nutrients, regardless of the use of dentures. The majority of efforts to improve frailty have focused on nutrition strategies, while the influence of teeth on dietary restraint of the elderly has been neglected.

The findings of the analysis suggested that the use of denture could be a neglected intervention that could potentially have a preventative impact on musculoskeletal frailty. The results also highlight the importance of developing oral health policies to ensure older adults maintain functional dentition throughout their life.